Zhang Q, Liu CD, Lu XX, Zhang SS, Gong JH, Ding J. Effect of stratified management and stepwise training on pulmonary rehabilitation in older patients with liver cancer. World J Gastrointest Surg 2025; 17(11): 110973 [DOI: 10.4240/wjgs.v17.i11.110973]
Corresponding Author of This Article
Juan Ding, Associate Chief Nurse, Department of Nursing Administration, Jingzhou Hospital Affiliated to Yangtze University, No. 26 Chuyuan Avenue, Jingzhou District, Jingzhou 434000, Hubei Province, China. 308722048@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nov 27, 2025 (publication date) through Nov 25, 2025
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Zhang Q, Liu CD, Lu XX, Zhang SS, Gong JH, Ding J. Effect of stratified management and stepwise training on pulmonary rehabilitation in older patients with liver cancer. World J Gastrointest Surg 2025; 17(11): 110973 [DOI: 10.4240/wjgs.v17.i11.110973]
Qiao Zhang, Chang-Dan Liu, Xiao-Xiao Lu, Shu-Shan Zhang, Department of Hepatobiliary Surgery, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou 434000, Hubei Province, China
Jian-Hua Gong, Department of Respiratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou 434000, Hubei Province, China
Juan Ding, Department of Nursing Administration, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou 434000, Hubei Province, China
Author contributions: Zhang Q designed the study; Liu CD, Lu XX, Zhang SS, and Gong JH were involved in data collection and manuscript preparation; Ding J reviewed and wrote the manuscript. All the authors have read and approved the final version of the manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of the Jingzhou Hospital Affiliated to Yangtze University (Approval No. 2025-162-01).
Informed consent statement: All study participants and their legal guardians provided written informed consent before enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Juan Ding, Associate Chief Nurse, Department of Nursing Administration, Jingzhou Hospital Affiliated to Yangtze University, No. 26 Chuyuan Avenue, Jingzhou District, Jingzhou 434000, Hubei Province, China. 308722048@qq.com
Received: July 15, 2025 Revised: August 18, 2025 Accepted: October 11, 2025 Published online: November 27, 2025 Processing time: 132 Days and 18.8 Hours
Abstract
BACKGROUND
Older patients with liver cancer often experience impaired pulmonary function post-surgery, increasing complications and recovery challenges.
AIM
To investigate the effects of evidence-based stratified management and stepwise training in the perioperative pulmonary rehabilitation of older patients with liver cancer, providing a basis for clinical application.
METHODS
In total, 120 older patients with liver cancer who underwent surgery at our hospital between February 2023 and February 2025 were selected and randomly divided into study and control groups, with 60 patients in each group. All the patients underwent radical hepatectomy. Postoperatively, the control group received routine nursing management and rehabilitation training, while the study group received evidence-based stratified management combined with stepwise training for a continuous intervention period of one week. Time to first ambulation, length of hospital stays, and average hospitalization costs were recorded. Oxygen saturation (SPO2) was measured on postoperative day 1 and day 3. The 6-minute walk distance and Borg scale scores were assessed on postoperative day 1 and day 7, respectively. The postoperative complication rates were recorded.
RESULTS
The study group had a significantly shorter time to first ambulation, shorter hospital stays, and lower average hospitalization costs than the control group (P < 0.05). On postoperative day 1, there was no significant difference in SPO2 between the groups (P > 0.05); however, on postoperative day 3, the study group had significantly higher SPO2 (P < 0.05). On postoperative day 7, the study group showed a significantly longer 6-minute walk distance and lower Borg scores than the control group (P < 0.05). The incidence of postoperative complications in the study group was 3.33%, which was significantly lower than that in the control group (13.33%; P < 0.05).
CONCLUSION
Implementing evidence-based stratified management combined with stepwise training in the perioperative pulmonary rehabilitation of older patients with liver cancer is improves lung function, reduces complications, and promotes effective recovery, demonstrating significant clinical value.
Core Tip: This study evaluated a novel rehabilitation strategy that combined evidence-based stratified management and stepwise training in older patients with liver cancer. The findings indicated that this approach enhanced postoperative recovery, improved pulmonary function, shortened hospital stay, and reduced complication rates, thereby supporting its clinical application in perioperative pulmonary rehabilitation.
